Comparative effectiveness research is increasingly becoming an essential tool in health care research, and decision-making, and quality improvement process. The newly enacted health care reform establishes a new perspective of health care services with emphasis and incentives for cost-containment and efficient utilization of resources. The paucity of critical comparative cost-effectiveness information to assess intervention options that will enable care providers, consumers, decision-making parties as well as other stakeholders to make informed decisions and choices on available alternatives could hamper the realization of the potentially accruable benefits of the new health care reform. The state of Florida suffers from a very costly health care system with global annual health care expenditure growth, personal health care and per capita health care expenditures that exceed the national average. The virtual absence of reliable and rigorously validated large, clinically enhanced administrative databases statewide hinders the ability of public health and other researchers to offer evidence-based data that could inform decision-making and improve efficient utilization of health care resources in the state. It is for this reason that the project in this grant proposal is capital for the state because it envisages filling this gap, which is a necessary step if Florida is to succeed in achieving a cost-effective and efficient health care delivery system in the future under the newly enacted national health care reform. The choice of maternal and child health as a focus is timely and well-informed because despite huge spending, Florida is performing below average compared to the rest of the nation in preventing maternal deaths and preterm births. It is for these reasons that we propose this study with the following specific aims: Specific Aim 1: To create an expanded clinically enhanced maternal-infant dataset for the State of Florida by augmenting the current statewide hospitalization data files through linkages to other data sources;Specific Aim 2: To validate the created dataset in Specific Aim 1 through a rigorous process that will establish confidence in the use of the dataset by the public;Specific Aim 3: To demonstrate the utility of the newly created enriched dataset in conducting comparative effectiveness analysis using early term elective delivery as a case study. The dataset from the project will encompass information from the following data sources: the birth certificate, in-patient hospital discharge data, ambulatory and emergency department data, financial data and Florida maternal mortality data. The success of the project is assured because the undertaking is based on an existing firm statewide partnership that has already completed an earlier data linkage activity that resulted in a refined dataset which will serve as the main template for the activities proposed for this grant. The project is important for Florida because it could lead to research that will provide critical information required to enable health care stakeholders effectively promote best clinical practices and to monitor quality improvement with the overall objective of enhancing maternal-infant health in the state. PUBLIC HEALTH RELEVANCE: The aim of this study is to create a reliable large statewide database that contains clinical and non-clinical information which will be useful for comparative effectiveness research and will serve as a tool for quality improvement with the overall objective of enhancing overall population health. The newly created dataset from the project will encompass information from the following data sources: the birth certificate, in-patient hospital discharge data, ambulatory and emergency department data, financial data and Florida maternal mortality data. The proposed project enjoys a strong statewide collaborative partnership that has been working together for sometime now to attain some of the objectives spelled out for this grant, and hence, the proposal has a very high probability of success.